Analysis of risk factors and dual-energy CT features of uric acid calculi

doi:10.3877/cma.j.issn.1674-3253.2024.04.010

Abstract

Abstract:

Objective

To analyze the clinical characteristics of patients with uric acid stones, explore the risk factors for uric acid stone formation, and evaluate the value of dual-energy CT in predicting uric acid stones.

Methods

A retrospective analysis was conducted on the clinical data of 75 patients with uric acid stones who visited the Department of Urology at the Second Affiliated Hospital of Nantong University from March 2017 to November 2020. A control group was set up with 75 healthy individuals who had no history of stones during the same period. The clinical characteristics of the two groups were analyzed and compared, and the risk factors for the formation of uric acid stones were further analyzed using logistic regression. Simultaneously analyze the sensitivity and specificity of dual-energy CT in predicting uric acid stones.

Results

Compared with the control group, the uric acid stone group had a higher proportion of males, lower urine pH, and a higher likelihood of urinary tract infections. Blood creatinine, calcium, sodium, and uric acid were higher in the control group than in the control group. Multivariate Logistic regression analysis showed that male, low urine pH, high blood calcium, and high blood uric acid were risk factors for the formation of uric acid stones. The sensitivity and specificity of dual-energy CT for predicting uric acid stones are 97.44% and 100%, respectively.

Conclusions

The formation of uric acid stones may be related to gender, urine pH, blood calcium, and blood uric acid. Dual-energy CT can predict uric acid stones to a certain extent.

Key words: Uric acid calculi, Risk factors, Dual-energy CT

Jie Jiang, Cheng Shen, Yongsheng Pan, Xinfeng Chen, Zhenmin Liu, Hua Zhu, Bing Zheng. Analysis of risk factors and dual-energy CT features of uric acid calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 361-365.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2024.04.010

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2024/V18/I04/361

Figures/Tables 6

References 24

[1]	Skolarikos A, Jung H, Neisius A, et al. EAU Guidelines on urolithiasis [EB/OL].[2024-04-08]. URL
[2]	Wang K, Ge J, Han W, et al. Risk factors for kidney stone disease recurrence: a comprehensive meta-analysis[J]. BMC Urol, 2022, 22(1): 62.
[3]	Forbes CM, McCoy AB, Hsi RS. Clinician versus nomogram predicted estimates of kidney stone recurrence risk[J]. J Endourol, 2021, 35(6): 847-852.
[4]	Cicerello E. Uric acid nephrolithiasis: an update[J]. Urologia, 2018, 85(3): 93-98.
[5]	Tran TVM, Maalouf NM. Uric acid stone disease: lessons from recent human physiologic studies[J]. Curr Opin Nephrol Hypertens, 2020, 29(4): 407-413.
[6]	Chen HW, Chen YC, Lee JT, et al. Prediction of the uric acid component in nephrolithiasis using simple clinical information about metabolic disorder and obesity: a machine learning-based model[J]. Nutrients, 2022, 14(9): 1829.
[7]	Wang Z, Zhang Y, Zhang J, et al. Recent advances on the mechanisms of kidney stone formation (Review)[J]. Int J Mol Med. 2021, 48(2): 149.
[8]	Schwaderer AL, Raina R, Khare A, et al. Comparison of risk factors for pediatric kidney stone formation: the effects of sex[J]. Front Pediatr, 2019, 7: 32.
[9]	Sorokin I, Mamoulakis C, Miyazawa K, et al. Epidemiology of stone disease across the world[J]. World J Urol, 2017, 35(9): 1301-1320.
[10]	Bargagli M, Ferraro PM, Vittori M, et al. Calcium and vitamin D supplementation and their association with kidney stone disease: a narrative review[J]. Nutrients, 2021, 13(12): 4363.
[11]	Wagner CA. Etiopathogenic factors of urolithiasis[J]. Arch Esp Urol, 2021, 74(1): 16-23.
[12]	Zeng G, Zhu W, Robertson WG, et al. International Alliance of Urolithiasis (IAU) Guidelines on the metabolic evaluation and medical management of urolithiasis[J]. Urolithiasis, 2022, 51(1):4.
[13]	Trinchieri A, Montanari E. Biochemical and dietary factors of uric acid stone formation[J]. Urolithiasis, 2018, 46(2): 167-172.
[14]	Espinosa-Ortiz EJ, Eisner BH, Lange D, et al. Current insights into the mechanisms and management of infection stones[J]. Nat Rev Urol, 2019, 16(1): 35-53.
[15]	Choy SH, Nyanatay SA, Sothilingam S, et al. Cardiovascular risk factors, ethnicity and infection stone are independent factors associated with reduced renal function in renal stone formers[J]. PLoS One, 2022, 17(4): e0265510.
[16]	Williams JC Jr, Gambaro G, Rodgers A, et al. Urine and stone analysis for the investigation of the renal stone former: a consensus conference[J]. Urolithiasis, 2021, 49(1): 1-16.
[17]	Borofsky MS, Handa RK, Evan AP, et al. In vivo renal tubule pH in stone-forming human kidneys[J]. J Endourol, 2020, 34(2): 203-208.
[18]	Kim JC, Cho KS, Kim DK, et al. Predictors of uric acid stones: mean stone density, stone heterogeneity index, and variation coefficient of stone density by single-energy non-contrast computed tomography and urinary pH[J]. J Clin Med, 2019, 8(2): 243.
[19]	Nourian A, Ghiraldi E, Friedlander JI. Dual-energy CT for urinary stone evaluation[J]. Curr Urol Rep, 2020, 22(1): 1.
[20]	Appel E, Thomas C, Steuwe A, et al. Evaluation of split-filter dual-energy CT for characterization of urinary stones[J]. Br J Radiol, 2021, 94(1127): 20210084.
[21]	Carbone A, Al Salhi Y, Tasca A, et al. Obesity and kidney stone disease: a systematic review[J]. Ital J Urol Nephrol, 2018, 70(4): 393-400.
[22]	Wollin DA, Skolarikos A, Preminger GM. Obesity and metabolic stone disease[J]. Curr Opin Urol, 2017, 27(5): 422-427.
[23]	Prasanchaimontri P, Monga M. Predictive factors for kidney stone recurrence in type 2 diabetes mellitus[J]. Urology, 2020, 143: 85-90.
[24]	Kim S, Chang Y, Jung HS, et al. Glycemic status, insulin resistance, and the risk of nephrolithiasis: a cohort study[J]. Am J Kidney Dis, 2020, 76(5): 658-668.e1.

指标	尿酸结石组（n=75）	对照组（n=75）	统计值	P值
年龄[岁，(±s)]	59±11	56±12	t=1.700	0.091
BMI[kg/m²，(±s)]	26±3	25±3	t=1.722	0.087
肥胖[例(%)]			χ²=0.176	0.675
是	15(20.00)	13(17.33)
否	60(80.00)	62(82.67)
性别[例(%)]			χ²=25.490	<0.001
男	65(86.67)	36(48.00)
女	10(13.33)	39(52.00)
合并高血压[例(%)]			χ²=1.556	0.212
是	26(34.67)	19(25.33)
否	49(65.33)	56(74.67)
合并糖尿病[例(%)]			χ²=0.923	0.337
是	12(16.00)	8(10.67)
否	63(84.00)	67(89.33)
合并痛风[例(%)]			χ²=0.257	0.612
是	3(4.00)	1(1.33)
否	72(96.00)	74(98.67)
地区分布[例(%)]			χ²=5.446	0.488
市区	30(40.00)	38(50.67)
海门区	2(2.67)	3(4.00)
海安市	6(8.00)	4(5.33)
如皋市	17(22.67)	9(12.00)
如东县	4(5.33)	3(4.00)
启东市	4(5.33)	2(2.67)
通州区	12(16.00)	16(21.33)

指标	尿酸结石组（n=75）	对照组（n=75）	统计值	P值
年龄[岁，(±s)]	59±11	56±12	t=1.700	0.091
BMI[kg/m²，(±s)]	26±3	25±3	t=1.722	0.087
肥胖[例(%)]			χ²=0.176	0.675
是	15(20.00)	13(17.33)
否	60(80.00)	62(82.67)
性别[例(%)]			χ²=25.490	<0.001
男	65(86.67)	36(48.00)
女	10(13.33)	39(52.00)
合并高血压[例(%)]			χ²=1.556	0.212
是	26(34.67)	19(25.33)
否	49(65.33)	56(74.67)
合并糖尿病[例(%)]			χ²=0.923	0.337
是	12(16.00)	8(10.67)
否	63(84.00)	67(89.33)
合并痛风[例(%)]			χ²=0.257	0.612
是	3(4.00)	1(1.33)
否	72(96.00)	74(98.67)
地区分布[例(%)]			χ²=5.446	0.488
市区	30(40.00)	38(50.67)
海门区	2(2.67)	3(4.00)
海安市	6(8.00)	4(5.33)
如皋市	17(22.67)	9(12.00)
如东县	4(5.33)	3(4.00)
启东市	4(5.33)	2(2.67)
通州区	12(16.00)	16(21.33)

指标	尿酸结石组（n=75）	对照组（n=75）	统计值	P值
尿液pH[M(Q)]	5.5(5，6)	6.0(6，6.5)	Z=5.374	<0.001
尿路感染[例(%)]			χ²=6.039	0.014
是	42(56.00)	27(36.00)
否	33(44.00)	48(64.00)
亚硝酸盐[例(%)]			χ²=0.107	0.743
阳性	6(8.00)	4(5.33)
阴性	69(92.00)	71(94.67)

指标	尿酸结石组（n=75）	对照组（n=75）	统计值	P值
尿液pH[M(Q)]	5.5(5，6)	6.0(6，6.5)	Z=5.374	<0.001
尿路感染[例(%)]			χ²=6.039	0.014
是	42(56.00)	27(36.00)
否	33(44.00)	48(64.00)
亚硝酸盐[例(%)]			χ²=0.107	0.743
阳性	6(8.00)	4(5.33)
阴性	69(92.00)	71(94.67)

指标	尿酸结石组（n=75）	对照组（n=75）	统计值	P值
血尿素氮	6.4±1.7	6.0±1.6	t=1.157	0.249
血肌酐	84(71，103)	61(49，72)	Z=6.707	<0.001
血钙	2.29±0.11	2.21±0.11	t=4.513	<0.001
血磷	1.03±0.21	1.04±0.14	t=0.216	0.830
血钠	142.9±2.6	141.9±2.1	t=2.638	0.009
血镁	0.93±0.13	0.92±0.66	t=0.917	0.361
血钾	3.97±0.38	3.87±0.28	t=1.894	0.060
血尿酸	395±114	294±56	t=6.853	<0.001

Please choose a citation manager

Content to export